Sunday, May 10, 2009

A.I.D.S. has been with us for a couple of decades now, but how much do we know about it? Its story has unfolded through countless articles across space and time, making it a little hard to follow.

Enter Elizabeth Pisani, an epidemiologist (and excellent story-teller) who's been in the thick of the international fight against AIDS from its earliest days. In The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS, she gives the straight dope on what happened -- where, when, and why -- with a focus on using data and evidence to track how the virus is spread, and on how to use that knowledge effectively to stop it. She has no time for euphemisms. Both liberal hand-wringing about stigmatizing affected groups and conservative/puritanical fear of the realities of sex and drugs can be obstacles to solving the problem.

The central dilemma is whether or not to push the claim that everyone is at risk. Pisani argues (with some impressive evidence to back her up) that HIV doesn't spread efficiently enough to stray very far from the high-risk groups: sex workers, men who have sex with men, injecting drug users, and people in southern and eastern Africa. The problem is that when you admit that AIDS won't kill us all, it's harder to drum up the sympathy (hence funds) necessary to effectively fight it, but when you exaggerate the proportion of so-judged "innocent" victims, you wind up with funds that have strings attached -- strings which tie your hands away from doing the very things that have been shown to prevent the spread of HIV: getting clean needles to drug users (including in prison), and getting sex workers and Africans to use condoms.

Same here! I picked it up because I thought it would be interesting to read something about the sex industry. And there definitely is a fair amount about the sex industry, but I'm glad it led me to this other topic (the AIDS industry). I've kind of half-assedly followed AIDS news (like everybody else), but didn't have a very coherent picture of the situation. This will give you a far clearer picture of what we've learned, where we're at, and what's to be done. One blurb on the cover said "An important book" -- and I kind of scoffed -- but now I totally agree.

AIDS has been with us for almost half of my life and pretty much all of my daughter's life. Like so many others I've lost countless friends and people I love to this ongoing plague; and the holes where those people were have never been filled. Who can take Dale's place? Or John's? Or Tony's? Or Richard's?

So many of my generation are gone and it's difficult sometimes to not feel the weight of such a tremendous loss. I avoid reading about HIV and AIDS because it's painful to be reminded not only of where we've been but of where we still are. And yet I know that information is valuable and knowledge is power. I want to read this book, I really do. But I'm not sure I could handle it. I'll go buy it and try it but if the tears start to flow I may have to put it down and just trust that it's everything you say it is Chanson.

I photographed Dale up in the Sierra Madre Forest north of Los Angeles - he was beautiful crouched naked against the rocks in a dry river bed. He helped me build and install the floors for the loft in my photography studio in Hollywood. And then a couple of weeks later I went to see him in the hospital and his body was bloated, he was covered with purple sarcomas, his eyes and mouth swollen shut and he could not see or speak or move or do anything but lie there and die. I kissed him goodbye on his cheek and turned and walked away.

Away yet again from yet another friend taken from us by a plague that Reagan refused to even acknowledge was happening. Many of us can't even tell our stories anymore because it hurts too much to remember. There's lots we need to know but wow, the memories are tough to wade through.

This book isn't so much about the tragedy of the generation who died when the disease first struck. Pisani was around from the beginning of the international fight against AIDS, but she started out at the U.N. policy level. She wasn't in the trenches with the Gay Men's Health Crisis Center.

She does talk quite a bit, though, about how amazing and exceptional it was the way the lay people of the gay community mobilized to fight the disease.